title: Home nebulizer use among patients with cystic fibrosis.
abstract: OBJECTIVE
  To describe current patterns of home nebulizer use among patients with cystic fibrosis.
  
  
  METHODS
  A population-based survey of home nebulizer practices among 227 patients with cystic fibrosis using nebulizers from 1993 to 1994 (Objective 1), and a prospective study of "typical" home use, including testing of performance and bacterial cultures in nebulizers after use, completed by 36 subjects (Objective 2).
  
  
  RESULTS
  Objective 1: 85% of subjects reported using jet and 8% ultrasonic nebulizers (categories not mutually exclusive); 15% used unknown brands. Most jet nebulizers were disposable models, which were used for > 14 days by more than half the subjects. Mixing of medications in a single treatment (other than cromolyn and a bronchodilator) was reported by 28% of patients. Objective 2: no apparent deterioration in aerosol particle size or output rate of returned nebulizers compared with new units was observed. Staphylococcus aureus was cultured from 55% and Pseudomonas aeruginosa from 35% of returned nebulizers. Concordance between nebulizer and sputum cultures was poor.
  
  
  CONCLUSIONS
  Although not generally tested for reusability, disposable nebulizers are generally used by patients for long periods. Medication mixing is common, although its effects on aerosol properties are unknown. Cystic fibrosis respiratory pathogens are frequently isolated from used nebulizers. Patient guidelines for home nebulizer use need to be established.
authors.affiliation: Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Rosenfeld
authors.forename: J
authors.initials: J
authors.lastname: Emerson
authors.forename: S
authors.initials: S
authors.lastname: Astley
authors.forename: P
authors.initials: P
authors.lastname: Joy
authors.forename: J
authors.initials: J
authors.lastname: Williams-Warren
authors.forename: T A
authors.initials: TA
authors.lastname: Standaert
authors.forename: D L
authors.initials: DL
authors.lastname: Yim
authors.forename: D
authors.initials: D
authors.lastname: Crist
authors.forename: M
authors.initials: M
authors.lastname: Thykkuttathil
authors.forename: M
authors.initials: M
authors.lastname: Torrence
authors.forename: S
authors.initials: S
authors.lastname: FitzSimmons
authors.forename: B
authors.initials: B
authors.lastname: Ramsey
mesh_terms: D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000628:therapy*; D004866:Equipment Contamination; D005260:Female; D006701:Home Nursing; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers / Q000382:microbiology / Q000592:standards; D011446:Prospective Studies; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012189:Retrospective Studies; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013223:Statistics as Topic